Chapter 35 – Head and Neck

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1、CHAPTER35HEADANDNECKRobertR.Lorenz,MarionE.Couch,andBrianB.Burkeyarytenoidcartilagesarecomposedofhyalinecartilage,whereasnormalhistologytheepiglottis,cuneiform,andcorniculatecartilagesarecom-epidemiologyposedofelastic-typecartilage.Theexternalearisacutaneouscarcinogenesisstructurelinedwithkeratini

2、zingsquamousepitheliumandasso-stagingciatedadnexalstructures.Theexternalthirdoftheexternalclinicaloverviewauditorycanalisuniqueinthatitcontainsmodifiedapocrineanatomicsitesglandsthatproducecerumen.Themiddleearislinedwithtracheotomyrespiratoryepithelium.vocalcordparalysisNumerousnoncancerouschanges

3、insquamousepitheliumreconstructioncanbeseenintheupperaerodigestivetract.Leukoplakia,whichdescribesanywhitemucosallesion,anderythroplasia,whichdescribesanyredmucosallesion,arebothclinicaldescriptionsandshouldnotbeusedasdiagnosticterms(Fig.35-1).Eryth-NORMALHISTOLOGYroplakiaismoreoftenindicativeofan

4、underlyingmalignantThenormalhistologyoftheupperaerodigestivetractvariesinlesion.Hyperplasiareferstothickeningoftheepitheliumsec-eachsite.Acompletereviewofthethyroidandparathyroidondarytoanincreaseinthetotalnumberofcells.Parakeratosisglandsisbeyondthescopeofthischapter.Thenasalvestibuleisanabnormal

5、presenceofnucleiinthekeratinlayers,whereasisconsideredacutaneousstructureandislinedbykeratinizingdyskeratosisreferstoanyabnormalkeratinizationofepithelialsquamousepithelium.Thelimennasi,ormucocutaneousjunc-cellsandisfoundindysplasticlesions.Koilocytosisisadescrip-tion,iswheretheepitheliumchangesto

6、aciliatedpseudostrati-tivetermforthevacuolizationofsquamouscellsandissugges-fiedcolumnar(respiratory)epitheliumtolinethenasalcavities.tiveofviralinfection,especiallyhumanpapillomavirus(HPV).Theexceptionistheolfactoryepitheliumattheroofofthenasalcavity,whichiscomposedofbipolar,spindle-shapedolfacto

7、ryEPIDEMIOLOGYneuralcellswithsurroundingsupportingcells.TheparanasalTheAmericanJointCommitteeonCancer(AJCC)stagingsinusesarealsolinedbyrespiratoryepithelium,butittendstosystemdividessitesofmalignancyoriginatingin